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There are no clinically relevant tools to easily identify CVD risk in adults with spinal cord injury (SCI), despite CVD being an established long-term complication of SCI. Our objectives were to (1) determine prevalence of metabolic syndrome (MetS) in this population using four published definitions and to compare this to prevalence in the general population (GP), and (2) develop a more sensitive definition of MetS for the SCI population. 38 community-dwelling men with SCI to date have participated in a cross-sectional study in which fasting lipids, insulin, glucose, C-reactive protein and anthropometric data were measured. MetS prevalence was determined using World Health Organization (WHO), National Cholesterol Education Program (NCEP), National Heart, Lung and Blood Institute / American Heart Association (NHLBI/AHA) and International Diabetes Federation (IDF) definitions. Agreement between definitions ranged from kappa values of-0.54 (WHO and IDF, NS) to 0.72 (NCEP and NHLBI, P<0.001). Prevalence of MetS ranged from 2.8% (WHO) to 21.1% (IDF) in SCI subjects and 13.2% (NHLBI/AHA) to 30.0% (IDF) in GP. Data collection and analysis are underway to develop a more sensitive MetS definition for this population. Most current MetS definitions are in fair to poor agreement and likely underestimate MetS prevalence in the SCI population relative to GP. [ABSTRACT FROM AUTHOR]

Abdominal fat increases cardiovascular disease (CVD) risk. Despite a higher prevalence of CVD in the chronic spinal cord injury (SCI) population, abdominal fat in those with vs. without SCI has not been determined. Our objectives were to (1) compare total (TAT), visceral (VAT), subcutaneous (SAT) and the ratio of visceral to subcutaneous (V/S) abdominal adipose tissue in adults with chronic SCI with that of age-, sex- and waist circumference (WC)-matched able-bodied (AB) controls; and (2) determine the relationship between WC and VAT in both groups. 28 adults (14 SCI, 14 AB) participated in this cross-sectional study. Abdominal fat was quantified by computed tomography. WC was measured at three sites (lowest rib, iliac crest, midpoint between the two). The V/S ratio was 45% greater in the SCI vs. AB group (0.48±0.23 vs. 0.33±0.14, p<0.05). After adjusting for differences in body weight, TAT and SAT were not different, however VAT was 64% greater in the SCI group (p<0.01). WC at all sites was associated with VAT in both groups (SCI: 0.863 ≤ r ≤ 0.892, AB: 0.821 ≤ r ≤ 0.852, both p<0.001). Analysis of metabolic risk factors is in progress. The higher VAT and V/S ratio may explain, in part, the higher prevalence of CVD in those with SCI. WC appears to be a valid surrogate measure of VAT in this population, providing a tool for clinicians to identify those at risk for CVD. [ABSTRACT FROM AUTHOR]